Aim. To identify clinical and functional manifestations of hypervolemia in patients with arterial hypertension (AH). Material and methods. In total, 440 patients with Stage I-II AH were examined, including assessment of salt taste sensitivity threshold (STST), 24-hour urinary Na excretion, and NaCl excretion. In addition, 24-hour blood pressure monitoring (BPM), echocardiography (EchoCG), and psychological status assessment (SMOL, MOS SF-36) were performed. Results. In 50,5% of AH patients, daily salt intake (assessed by 24-hour NaCl excretion) was ≥16,8 g, due to adding salt to food, as well as to reduced STST. Higher salt intake was associated with more advanced clinical and functional AH manifestations. Indirect markers of hypervolemia in AH patients included higher salt intake, low effectiveness of standard antihypertensive therapy (AHT), disturbed circadian BP rhythm with inadequate nighttime BP reduction, and EchoCG signs of left ventricular volume overload. Conclusion. Complex examination of AH patients helps to identify individuals with clinical and functional manifestations of hypervolemia.
To evaluate neurogenic theory of essential hypertension taking into account the recently obtained findings. Design and methods. We analyzed evidence data and our own results from a group of 630 hypertensive patients. The threshold of their gustatory sensation to dietary salt (DS), urinary sodium excretion, daily blood pressure monitoring, echocardiography, cardiointervalography were studied; psychological state was assessed. The control group consisted of 350 healthy persons. Results. According to our data, inсreased DS consumption is the main factor leading to clinical and functional manifestations of arterial hypertension. According to the literature data citizens of blocked Leningrad obtained excessive amount of DS that could be the main cause of the epidemic of arterial hypertension in the blocked city. Conclusions. Decrease of DS consumption by population is fundamental preventive measure of lowering hypertension prevalence
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